Laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision
10.3760/cma.j.issn.1673-4203.2017.05.010
- VernacularTitle:无腹部小切口全腔镜Ivor Lewis食管癌切除术的临床应用
- Author:
Zhenghua ZHANG
;
Jieyong TIAN
;
Mingfa GUO
;
Meiqing XU
- Keywords:
Esophageal neoplasms;
Ivor Lewis esophagectomy;
Small incision;
Laparoscopes;
Intraoperative complications
- From:
International Journal of Surgery
2017;44(5):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and clinical effect of laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision.Methods Compared 80 cases underwent laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision with 68 patients receivesd laparoscopic and thoracoscopic Ivor Lewis esophagectomy with an abdominal small incision.The peri operative conditions and complications of the two groups were analyzed.Results There were no significant difference in the operation time [(263.3 ± 71.5) min vs (273.3 ± 73.7) min,t =-0.750,P =0.454],intraoperative blood loss [(246.9 ± 150.4) ml vs (252.9 ± 159.7) ml,t =-0.238,P =0.812],the number of lymph node dissection [(19.2 ±4.3) vs (19 ±4.5),t =0.272,P =0.786],gastrointestinal decompression time [(11 ± 3.4) d vs (11.9±3.3) d,t=-1.647,P=0.102],chest tube indwelling time [(6.6±2.7) d vs (6.3±2.6) d,t=0.544,P=0.587],postoperative hospitalization time [(13.2 ±3.4) d vs (14 ±3.4) d,t=-1.493,P=0.138] and rate of early gastric emptying dysfunction [6.25％ (5/80) vs 4.41％ (3/68),x2 =0.016,P =0.898].Comparing to patients in the small incision group,the visual analogue scale evaluation score of postoperative pain was lower in the groups without small incision (P ＜ 0.05).There were no anastomotic fistula,thoracic gastric fistula,upper gastrointestinal bleeding and death during perioperative periods.Conclusion It is safe and feasible to treat middle and lower esophageal carcinoma with laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision,which can further reduce abdominal trauma,relieve postoperative pain and make the abdominal incision more beautiful.
